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Diagnosis of Brain Tumors

When you appear with symptoms suggesting a brain tumor , the first step will be a complete investigation of those symptoms and your overall health. A physical exam will be done, paying particular attention to the neurologic exam. A neurologic exam tests muscle strength, coordination, reflexes, response to stimuli, your senses, thought processes, and alertness. The doctor may also look into your eyes to check for signs of brain swelling that can be seen by looking at your retina.

At this point, your doctor will either conduct further tests or refer you to a neurologist or neurosurgeon.

Tests

Tests may include:

  • MRI scan —a test that uses magnetic fields to make computerized pictures of the brain
  • CT scan —a type of x-ray that uses a computer to make pictures of structures inside the body
  • Angiography —a test that uses x-rays to make pictures of blood vessels after injection of contrast material into your blood circulation
  • Biopsy —removal of a sample of tumor tissue to test for cancer cells
  • Stereotactic biopsy—use of a computer-assisted CT or MRI scan to locate the tumor and take a biopsy
  • PET and SPECT scans—tests that detect the level of metabolic activity in the brain and other organs by tracking a radioactive substance that is injected into the bloodstream
  • Electroencephalogram (EEG)—a noninvasive test used to evaluate brain function or disorders
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Sometimes tests are combined. For instance, certain contrast agents can be injected into the bloodstream that will produce better images with CT or MRI scanning, thus combining angiography with computerized imaging. An example of this test is a CTA (CT angiogram) or MRA (magnetic resonance angiogram).

Characteristics of Tumors

Some important characteristics of a tumor are:

  • Type of tumor
  • Location
  • Size

These factors determine the symptoms, outlook, and treatment. It is important whether the tumor originated in the nervous system or spread there from somewhere else in the body.

Tumors are graded according to numerous features. All cancers are graded to identify the most promising treatment and to determine their outlook. In some cases, a biopsy cannot be safely performed. The doctors then estimate what type of brain tumor exists and make treatment plans accordingly.

Grading

Malignant brain tumors are graded on a numerical scale using one of several systems. The preferred grading system is by the World Health Organization (WHO). The tumor grades help predict the rate of tumor growth, its ability to spread, and its prognosis.

Patient Factors

The two most important factors that predict how well someone may do are the patient’s age and performance status. Younger patients generally do better, as do patients who have very few symptoms associated with their tumor. Age and performance status are always considered when planning treatment.

Revision Information

  • Brain tumor. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated May 28, 2013. Accessed June 4, 2013.

  • Brain tumor. National Cancer Institute website. Available at: http://www.cancer.gov/cancertopics/types/brain. Accessed June 4, 2013.

  • Louis DN, Ohgaki H, et al. WHO Classification of Tumors of the Central Nervous System. 4th ed. Lyon, France: International Agency for Research on Cancer; 2007.